Lower follicular n-3 polyunsaturated fatty acid levels are associated with a better response to ovarian stimulation

• Published in: Journal of assisted reproduction and genetics Vol. 36; no. 3; pp. 473 - 482
• Main Authors: Ruiz-Sanz, José-Ignacio, Pérez-Ruiz, Irantzu, Meijide, Susana, Ferrando, Marcos, Larreategui, Zaloa, Ruiz-Larrea, María-Begoña
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-03-2019; Springer Nature B.V
• Subjects: Adult; Age; Assisted Reproduction Technologies; Blastocyst - metabolism; Docosahexaenoic acid; Embryos; Fatty acids; Fatty Acids, Omega-3 - metabolism; Female; Fertility; Fertilization; Fertilization in Vitro; Follicles; Follicular fluid; Follicular Fluid - metabolism; Gas chromatography; Gynecology; Human Genetics; Humans; Infertility; Ionization; Medicine; Medicine & Public Health; Oocyte Retrieval; Oocytes; Oocytes - growth & development; Oocytes - metabolism; Oogenesis - genetics; Ovarian Follicle - growth & development; Ovarian Follicle - metabolism; Ovulation Induction - methods; Polyunsaturated fatty acids; Reproductive Medicine; Reproductive technologies; Women; Aging; Gas chromatography; Female infertility; Follicular fluid; Fatty acids
• ISSN: 1058-0468; 1573-7330
• DOI: 10.1007/s10815-018-1384-1

Objectives
To analyze in detail the fatty acid (FA) composition of follicular fluid (FF) from two-sized follicles at oocyte retrieval and to determine associations of the FAs from large follicles with the woman’s age and the response to ovarian stimulation.
Design
Observational study.
Setting
University and fertility clinic.
Patients
Sixty-four women (age 19–46), consisting of unfertile patients and oocyte donors, undergoing controlled ovarian stimulation.
Interventions
None.
Main outcome measure(s)
FF from small (< 12 mm) and large (≥ 18 mm) follicles was collected at oocyte retrieval. FAs by gas chromatography-flame ionization detection.
Result
Thirty-two FAs with chain lengths ranging from 14 to 25 carbons were identified. There was a readjustment in FA distribution as follicle size increased, raising very long-chain saturated FAs, nervonic (24:1n-9), arachidonic (20:4n-6), and n-3 polyunsaturated FAs (PUFA,
P
 < 0.001), the latter mainly due to an increase in docosahexaenoic acid (22:6n-3, DHA). In large follicles, double bond and peroxidizability indices and total n-3 PUFA, particularly DHA, correlated positively with the woman’s age and negatively with the number of total and mature oocytes, total and top-quality embryos, and fertilization rate.
Conclusions
We have described 32 FAs in ovarian FF, of which 16 changed their distribution with follicle size. The results also indicate that lower n-3 PUFA levels in large follicles, which are associated with younger women, predict a better response to ovarian stimulation based on the recovery of total and mature oocytes, total and top-quality embryos, and fertilization rate per cycle.
Key message
The fatty acid profile of ovarian FF changes as the follicle grows and lower n-3 PUFA levels in large follicles, associated with younger women, predict a better response to ovarian stimulation.